Functional and cognitive variables predicting successful use of chopsticks or a spoon by the paretic upper extremity in patients following stroke: a cross-sectional study

  • Kazuaki Iokawa
    Preparing Section for New Faculty of Medical Science, Fukushima Medical University, Fukushima, Japan
  • Toshimasa Sone
    Department of Rehabilitation, Faculty of Health Science, Tohoku Fukushi University, Sendai, Japan
  • Takaaki Fujita
    Department of Rehabilitation, Faculty of Health Science, Tohoku Fukushi University, Sendai, Japan
  • Tetsu Tsukada
    Department of Rehabilitation, Takeda General Hospital, Aizuwakamatsu, Japan
  • Mariko Kaneda
    Department of Rehabilitation, Takeda General Hospital, Aizuwakamatsu, Japan
  • Keiichi Hasegawa
    Department of Rehabilitation, Takeda General Hospital, Aizuwakamatsu, Japan

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The factors necessary for successful use of chopsticks or a spoon, by patients with a paretic upper extremity (UE) following stroke are unknown.We identified the functional capacities and interactions related to chopsticks or spoon use in patients with right hemiplegia following stroke.Participants were 139 stroke patients with right hemiplegia who required rehabilitation, divided into the following three categories: able to use chopsticks, able to use a spoon, or unable to use a spoon. We collected sociodemographic data, medical data, physical and cognitive function data, and functional grades associated with chopsticks or spoon use by the paretic dominant UE while eating. We identified a complex interaction of variables relating to functional use of chopsticks or a spoon using a classification and regression tree analytic process.Patients with UE Brunnstrom recovery stage (BRS)IV, and a Hasegawa Dementia Scale - Revised (HDS-R) score16 had a 91.3% probability of being able to use chopsticks. Moreover, patients with a UE BRS ofIV, and the HDS-R score ≤16 had a 66.7% probability of being able to use a spoon. By contrast, patients with a UE BRS of ≤IV had a 90.5% probability of not being able to use a spoon.The interaction of BRS as a measure of UE function and HDS-R score as a measure of cognitive function affect the ability of patients with stroke histories to functionally use the paretic UE to operate chopsticks or a spoon.

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